TY - JOUR
T1 - Beyond Antoni: A Surgeon's Guide to the Vestibular Schwannoma Microenvironment
AU - Hannan, Cathal J.
AU - Lewis, Daniel
AU - O'Leary, Claire
AU - Donofrio, Carmine A.
AU - Evans, Dafydd G.
AU - Stapleton, Emma
AU - Freeman, Simon R.
AU - Lloyd, Simon K.
AU - Rutherford, Scott A.
AU - Hammerbeck-Ward, Charlotte
AU - Brough, David
AU - Allan, Stuart M.
AU - Coope, David
AU - King, Andrew T.
AU - Pathmanaban, Omar N.
N1 - Funding Information:
Aspects of this work were funded by Cancer Research, UK, and the Countess Dowager Eleanor Peel Trust. D.G.E. and S. K.L. are supported by the NIHR Manchester Biomedical Research Centre (IS-BRC-1215–20007). The authors declare no personal or financial interest in the investigative or treatment modalities described in this review article.
Publisher Copyright:
© 2022 Thieme Medical Publishers, Inc.. All rights reserved.
PY - 2022/2/1
Y1 - 2022/2/1
N2 - Introduction Vestibular schwannomas (VS) are histologically benign tumors arising from cranial nerve VIII. Far from a homogenous proliferation of Schwann cells, mounting evidence has highlighted the complex nature of the inflammatory microenvironment in these tumors. Methods A review of the literature pertaining to inflammation, inflammatory molecular pathways, and immune-related therapeutic targets in VS was performed. Relevant studies published up to June 2020 were identified based on a literature search in the PubMed and MEDLINE databases and the findings were synthesized into a concise narrative review of the topic. Results The VS microenvironment is characterized by a dense infiltrate of inflammatory cells, particularly macrophages. Significantly higher levels of immune cell infiltration are observed in growing versus static tumors, and there is a demonstrable interplay between inflammation and angiogenesis in growing VS. While further mechanistic studies are required to ascertain the exact role of inflammation in angiogenesis, tumor growth, and Schwann cell control, we are beginning to understand the key molecular pathways driving this inflammatory microenvironment, and how these processes can be monitored and targeted in vivo. Conclusion Observational research has revealed a complex and heterogeneous tumor microenvironment in VS. The functional landscape and roles of macrophages and other immune cells in the VS inflammatory infiltrate are, however, yet to be established. The antiangiogenic drug bevacizumab has shown the efficacy of targeted molecular therapies in VS and there is hope that agents targeting another major component of the VS microenvironment, inflammation, will also find a place in their future management.
AB - Introduction Vestibular schwannomas (VS) are histologically benign tumors arising from cranial nerve VIII. Far from a homogenous proliferation of Schwann cells, mounting evidence has highlighted the complex nature of the inflammatory microenvironment in these tumors. Methods A review of the literature pertaining to inflammation, inflammatory molecular pathways, and immune-related therapeutic targets in VS was performed. Relevant studies published up to June 2020 were identified based on a literature search in the PubMed and MEDLINE databases and the findings were synthesized into a concise narrative review of the topic. Results The VS microenvironment is characterized by a dense infiltrate of inflammatory cells, particularly macrophages. Significantly higher levels of immune cell infiltration are observed in growing versus static tumors, and there is a demonstrable interplay between inflammation and angiogenesis in growing VS. While further mechanistic studies are required to ascertain the exact role of inflammation in angiogenesis, tumor growth, and Schwann cell control, we are beginning to understand the key molecular pathways driving this inflammatory microenvironment, and how these processes can be monitored and targeted in vivo. Conclusion Observational research has revealed a complex and heterogeneous tumor microenvironment in VS. The functional landscape and roles of macrophages and other immune cells in the VS inflammatory infiltrate are, however, yet to be established. The antiangiogenic drug bevacizumab has shown the efficacy of targeted molecular therapies in VS and there is hope that agents targeting another major component of the VS microenvironment, inflammation, will also find a place in their future management.
KW - angiogenesis
KW - antiangiogenic
KW - bevacizumab
KW - biomarkers
KW - immunomodulation
KW - immunotherapy
KW - inflammation
KW - tumor immunology
KW - tumor-associated macrophages
KW - vestibular schwannoma
UR - https://publons.com/wos-op/publon/36582166/
U2 - 10.1055/s-0040-1716688
DO - 10.1055/s-0040-1716688
M3 - Review article
C2 - 35155063
VL - 83
SP - 1
EP - 10
JO - Journal of neurological surgery. Part B, Skull base
JF - Journal of neurological surgery. Part B, Skull base
SN - 2193-6331
IS - 1
ER -